Discharge Instructions for Pacemaker Implantation

You have had a procedure to insert a pacemaker. Once inside your body, this small electronic device helps keep your heart from beating too slowly.  As you recover, follow all of the instructions you are given, including those below.

Activity

• Don't drive until your doctor says it's OK. Plan to have someone drive you home after the procedure.

• For the first 24 hours after the procedure:
  • Do not operate heavy machinery.
  • Do not make any important decisions or sign legal documents. 

• Follow the instructions you are given about limiting your activity.

• If you are fitted with an arm sling, keep your arm in the sling for as long as your doctor tells you to. Most often, the sling will be removed the following day though you may be instructed to sleep with it on for a period to prevent damage to the pacemaker while it's healing.

• Do not raise your arm on the incision side above shoulder level or stretch your arm behind your back for as long as directed by your doctor. This gives the leads a chance to secure themselves inside your heart.

• Ask your doctor when you can expect to return to work. Depending on the type of work you do, you may have restrictions until your cardiologist clears you for unrestricted activity.

• You can still exercise. It's good for your body and your heart. Talk with your doctor about an exercise plan and the types of exercise to minimize the risk of damaging your pacemaker.

Home care

• Follow your doctor's directions carefully for wound care.
• Always wash your hands before touching your incision.
• Do not use any lotions, creams, ointments or peroxide on the incision site. 

• Every day, take your temperature and check your incision for signs of infection (redness, swelling, drainage, or warmth). Do this for 7 days or as advised by your doctor.

• Do not rub or twist the pacemaker.

• Learn to take your own pulse. Keep a record of your results. Ask your doctor what pulse rate means you should call for medical attention.

• Before you receive any treatment, tell all healthcare providers (including your dentist) that you have a pacemaker.

• You will be given an ID card that contains information about your pacemaker. Always carry this card with you. You can show this card if your pacemaker sets off a metal detector. You should also show it to avoid screening with a hand-held security wand.

• Keep your cell phone away from your pacemaker. Don't carry the phone in your shirt pocket overlying the pacemaker, even when it's turned off.

• Avoid strong magnets. Examples are those used in MRIs or in hand-held security wands. Some pacemakers are now safe to use with MRI scanners. Ask your doctor if you have such a pacemaker.

• Avoid strong electrical fields. Examples are those made by radio transmitting towers, "ham" radios, and heavy-duty electrical equipment.

• Avoid leaning over the open hood of a running car. A running engine creates an electrical field. Most household and yard appliances will not cause any problems. If you use any large power tools, such as an industrial arc welder, talk with your doctor.

Follow-up care

• You will see your doctor in about 2 weeks to check your implant site.  If you do not have an appointment already call and make an appointment as soon as you get home.
• Plan on having periodic check-ups with your healthcare provider to evaluate the battery life of your pacemaker. Depending on your device and how much your body uses the pacing functions of the pacemaker, you will need a new device generator implanted at some point, generally about every 5 to 7 years.
• Some pacemakers have a built-in antenna that can transmit information such as trouble alerts over the internet to your doctor. Ask your doctor if your pacemaker is capable of remote monitoring.

When to seek medical attention

• Chest pain
• Severe trouble breathing

• Dizziness
• Lack of energy
• Fainting spells
• Twitching chest muscles
• Rapid pulse or pounding heartbeat
• Shortness of breath
• Pain around your pacemaker
• Swelling of hand or arm on the same side as the pacemaker
• Fever above 100.4°F (38°C) or other signs of infection (redness, swelling, drainage, or warmth at the incision site)
• Your incision is not healing or your incision separates or opens
• Hiccups that won’t stop
• If your pacemaker generator feels loose or like it is wiggling in the pocket under the skin